| NPI | 1457439721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MA 2325) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-00244) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2008-05-21 |